What is liver failure?Liver failure - syndrome characterized by violation of one or many of the functions of the liver due to acute or chronic damage to its tissue.
There are acute and chronic liver failure, and its 3 stages: I stage - the initial (compensated), II stage - pronounced (decompensated) and stage III terminal (dystrophic). End-stage liver failure, liver coma ends.
Every year the world of fulminant (lightning), liver failure killed 2 million people. Mortality from this symptom is 50-80%.
Causes of liver failureAcute liver failure can occur when:
- Severe forms of viral hepatitis
- Industrial poisoning (arsenic, phosphorus, etc.)
- Herbal (non-edible mushrooms)
- Other hepatotropic poisons
- Some drugs (extract of male fern, tetracycline, etc.)
- Inogruppnoy blood transfusion and in some other cases.
Chronic liver failure occurs during the progression of many chronic liver disease (cirrhosis, cancers, etc. etc.).
Fulminant hepatic failure may be the outcome of viral hepatitis, autoimmune hepatitis, hereditary diseases (such as Wilson's disease) be the result of medication (eg, acetaminophen), exposure to toxic substances (eg, toxins pale toadstool). In 30% of cases, the cause of fulminant hepatic failure is not defined.
Symptoms of liver failureSymptoms flow depend on the nature of liver disease, acute course of the process.
Acute liver failure develops rapidly, over a few hours or days, and timely treatment may be reversible, etc.) can quickly trigger the development of hepatic coma.
Appears liver failure and reduced distortion of appetite, aversion to tobacco smokers, alcohol and food intolerance, nausea, and weakness, decreased ability to work, emotional disorders, and others.
Usually observed symptoms of the underlying disease that caused liver failure. Revealed many changes of biochemical parameters in serum (there is an increase of bilirubin, gamma-globulin, transaminases, decreased albumin, clotting factors, cholesterol esters, cholinesterase activity, etc.).
1 In stage symptoms may be absent. For stage II is characterized by clinical signs: unmotivated weakness, loss of earning capacity, dyspepsia (nausea, vomiting, diarrhea, yellow), the appearance and progression of jaundice, hemorrhagic diathesis (bleeding), ascites, and sometimes swelling. In stage III there are profound metabolic disturbances in the body, dystrophic conditions not only in the liver but also in other organs (nervous system, kidney, etc.), Chronic liver expressed cachexia (wasting). There are signs of impending hepatic coma.
Hepatic coma. In the development stage of hepatic coma separated precoma-threatening coma, and who actually.
In the period before the comatose is usually marked by progressive anorexia (lack of appetite), nausea, reducing the size of the liver, jaundice growth, rapid changes in blood chemistry.
In the future, picking up the neuro-psychiatric disorders, slow thinking, depression, and sometimes some euphoria. Characterized by mood instability, irritability, impaired memory, upset sleep. Characterized by small tremors (twitching) limbs. Under the influence of active treatment patients can out of it, but more often in severe irreversible changes in hepatic coma occurs.
During the coma can be excited, which is then followed by depression (stupor) and progressive impairment of consciousness up to the total loss of his. The patient's face sunken, cold extremities, mouth, and skin comes from the distinctive sweet smell of liver, hemorrhagic phenomena are amplified (skin hemorrhages, bleeding from the nose, gums, varicose veins of the esophagus, etc. etc.).
Prevention of liver failurePrevention of acute liver failure is reduced to the prevention of infectious and toxic liver damage.
Prevention of chronic liver disease is the timely treatment of diseases of the liver, which can serve as the cause.
Of great importance is the struggle with alcoholism.
ForecastThe prognosis for the timely treatment of acute liver failure favorable.
In chronic liver failure, poor, but in some cases, hepatic coma may regress (decrease) and for a number of months again recur (come back).
Forecast hepatic coma depends on its depth - in the early stages, with vigorous treatment may recover, at the stage of actual coma in most cases the process is irreversible.
What can your doctor do?The diagnosis is based on clinical and biochemical parameters. Treatment is carried out only in the hospital.
Treatment of hepatic failure should be started as early as possible in the early stages of the disease process. Treatment is carried out in several directions. When acute-onset hepatic failure and hepatic coma is very important to intensive treatment interventions to support the life of the patient during the critical period (a few days) before the regeneration of the liver (liver cells are able to recover for 10 days, if the cause of the disease).
Carry out the treatment of the underlying disease in toxic gepatozah measures aimed at removing toxic factor.
In chronic liver failure are treated with the underlying disease and symptomatic therapy. Patients with fulminant hepatic failure in need of a liver transplant.